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Journal of Nutrition Research
An official journal of IAPEN India association

Article

Journal of Nutrition Research

Year: 2024, Volume: 12, Issue: 1, Pages: 15-31

Guideline

IAPEN India: Consensus Guidance and Recommendation on Nutritional Management of Paediatric Cancer Patients

Received Date:21 December 2023, Accepted Date:15 May 2024, Published Date:18 June 2024

Abstract

Nutritional imbalances which occur as a result of the disease and its treatment are common problems in paediatric cancer patients. Malnutrition, which encompasses both overnutrition and undernutrition, directly impacts a child's growth, quality of life, treatment outcomes, and survival. Unfortunately, nutritional management of paediatric cancer patients is not standardised and uniform across the country due to the lack of national guidelines. This necessitates the formulation of guidelines and recommendations that will provide a systematic approach and help address the multiple nutritional challenges in paediatric cancer patients. While formulating this consensus statement, a cohort of experts comprising paediatric oncology nutrition experts and oncologists were selected from paediatric oncology centres across India. The committee thus formed put together clinical questions in different areas on identification, evaluation and management of nutritional issues in children undergoing treatment for cancer. An extensive literature search in PubMed was performed; the available evidence was discussed over eight meetings, and recommendations were drafted as per the committee members' discussion and consensus. Practical recommendations were proposed and deliberated upon wherever evidence in the literature was unavailable. Finally, the draft consensus statements and recommendations were approved by all the authors for publication and practice. With this paper, the committee aimed to present a consensus-based guidance for addressing the nutritional needs of children with cancer.

Keywords

Pediatric Oncology Nutrition, Nutritional Management, Consensus Recommendations and Guidance

References

    1. Hudson MM, Link MP, Simone JV. Milestones in the Curability of Pediatric Cancers. Journal of Clinical Oncology. 2014;32(23):2391–2397. Available from: https://dx.doi.org/10.1200/jco.2014.55.6571
    2. Triarico S, Rinninella E, Cintoni M, Capozza MA, Mastrangelo S, Mele MC, et al. Impact of malnutrition on survival and infections among pediatric patients with cancer: a retrospective study. Eur Rev Med Pharmacol Sci. 2019;23(3):1165–1175. Available from: https://doi.org/10.26355/eurrev_201901_17009
    3. Yadav SP, Rastogi N, Kharya G, Misra R, Ramzan M, Katewa S, et al. Barriers to Cure for Children with Cancer in India and Strategies to Improve Outcomes: A Report by the Indian Pediatric Hematology Oncology Group. Pediatric Hematology and Oncology. 2014;31(3):217–224. Available from: https://doi.org/10.3109/08880018.2014.893596
    4. Fabozzi F, Trovato CM, Diamanti A, Mastronuzzi A, Zecca M, Tripodi SI, et al. Management of Nutritional Needs in Pediatric Oncology: A Consensus Statement. MDPI AG. 2022. Available from: https://dx.doi.org/10.3390/cancers14143378
    5. Timmanpyati S, , Krishnamurthy A, Parikh P, Bajaj M, Gupta S, et al. IAPEN India : Nutrition Consensus Guidelines in Oncology Clinical Practice. Journal of Nutrition Research. 2021;9(1):8–18. Available from: https://dx.doi.org/10.55289/jnutres/v9i1.03
    6. Pedretti L, Massa S, Leardini D, Muratore E, Rahman S, Pession A, et al. Role of Nutrition in Pediatric Patients with Cancer. Nutrients. 2023;15(3):9920596. Available from: https://doi.org/10.3390/nu15030710
    7. Mehta NM, Comphe C. Clinical Guidelines: nutrition support of the critically ill child. JPEN J Parenter Enteral Nutr. 2009;33(3):260–276. Available from: https://doi.org/10.1177/0148607109333114
    8. Santarpia L, Contaldo F, Pasanisi F. Nutritional screening and early treatment of malnutrition in cancer patients. Journal of Cachexia, Sarcopenia and Muscle. 2011;2(1):27–35. Available from: https://dx.doi.org/10.1007/s13539-011-0022-z
    9. Murphy AJ, White M, Viani K, Mosby TT. Evaluation of the nutrition screening tool for childhood cancer (SCAN) Clinical Nutrition. 2016;35(1):219–224. Available from: https://doi.org/10.1016/j.clnu.2015.02.009
    10. Schoeman J. Nutritional assessment and intervention in a pediatric oncology unit. Indian Journal of Cancer. 2015;52(2):186. Available from: https://dx.doi.org/10.4103/0019-509x.175832
    11. Viani K, Trehan A, Manzoli B, Schoeman J. Assessment of nutritional status in children with cancer: A narrative review. Pediatric Blood & Cancer. 2020;67(S3):28211. Available from: https://dx.doi.org/10.1002/pbc.28211
    12. Joffe L, Ladas EJ. Nutrition during childhood cancer treatment: current understanding and a path for future research. The Lancet Child & Adolescent Health. 2020;4(6):465–475. Available from: https://doi.org/10.1016/S2352-4642(19)30407-9
    13. Gaynor EPT, Sullivan PB. Nutritional status and nutritional management in children with cancer. Archives of Disease in Childhood. 2015;100(12):1169–1172. Available from: https://doi.org/10.1136/archdischild-2014-306941
    14. Barr RD, Ladas EJ. The role of nutrition in pediatric oncology. Expert Review of Anticancer Therapy. 2020;20(2):109–116. Available from: https://doi.org/10.1080/14737140.2020.1719834
    15. Barr RD, Stevens MCG. The influence of nutrition on clinical outcomes in children with cancer. Pediatric Blood & Cancer. 2020;67(S3):28117. Available from: https://doi.org/10.1002/pbc.28117
    16. Murphy AJ, White M, Elliott SA, Lockwood L, Hallahan A, Davies PS. Body composition of children with cancer during treatment and in survivorship. The American Journal of Clinical Nutrition. 2015;102(4):891–896. Available from: https://dx.doi.org/10.3945/ajcn.114.099697
    17. Murphy AJ, White M, Davies PS. Body composition of children with cancer. The American Journal of Clinical Nutrition. 2010;92(1):55–60. Available from: https://dx.doi.org/10.3945/ajcn.2010.29201
    18. Hoed MAHd, Pluijm SMF, Groot-Kruseman HAd, Winkel MLt, Fiocco M, Akker ELTvd, et al. The negative impact of being underweight and weight loss on survival of children with acute lymphoblastic leukemia. Haematologica. 2015;100(1):62–69. Available from: https://dx.doi.org/10.3324/haematol.2014.110668
    19. Rayar M, Webber CE, Nayiager T, Sala A, Barr RD. Sarcopenia in Children With Acute Lymphoblastic Leukemia. Journal of Pediatric Hematology/Oncology. 2013;35(2):98–102. Available from: https://dx.doi.org/10.1097/mph.0b013e318279eea2
    20. Orgel E, Mueske NM, Sposto R, Gilsanz V, Freyer DR, Mittelman SD. Limitations of body mass index to assess body composition due to sarcopenic obesity during leukemia therapy. Leukemia & Lymphoma. 2018;59(1):138–145. Available from: https://doi.org/10.3109/10428194.2015.1136741
    21. Ladas EJ, Arora B, Howard SC, Rogers PC, Mosby TT, Barr RD. A Framework for Adapted Nutritional Therapy for Children With Cancer in Low- and Middle-Income Countries: A Report From the SIOP PODC Nutrition Working Group. Pediatric Blood & Cancer. 2016;63(8):1339–1348. Available from: https://dx.doi.org/10.1002/pbc.26016
    22. Israels T, Renner L, Hendricks M, Hesseling P, Howard S, Molyneux E. SIOP PODC: Recommendations for supportive care of children with cancer in a low‐income setting. Pediatric Blood & Cancer. 2013;60(6):899–904. Available from: https://dx.doi.org/10.1002/pbc.24501
    23. Leonard M, Dain E, Pelc K, Dan B, Laet CD. Nutritional status of neurologically impaired children: Impact on comorbidity. Archives de Pédiatrie. 2020;27(2):95–103. Available from: https://doi.org/10.1016/j.arcped.2019.11.003
    24. Osterkamp LK. Current Perspective on Assessment of Human Body Proportions of Relevance to Amputees. Journal of the American Dietetic Association. 1995;95(2):215–218. Available from: https://dx.doi.org/10.1016/s0002-8223(95)00050-x
    25. Ladas EJ, Sacks N, Meacham L, Henry D, Enriquez L, Lowry G, et al. A multidisciplinary review of nutrition considerations in the pediatric oncology population: a perspective from children's oncology group. Nutr Clin Pract. 2005;20(4):377–93. Available from: https://doi.org/10.1177/0115426505020004377
    26. Barr R, Collins L, Nayiager T, Doring N, Kennedy C, Halton J. Nutritional status at diagnosis in children with cancer. 2. An assessment by arm anthropometry. J Pediatr Hematol Oncol. 2011;33:101–104. Available from: https://doi.org/10.1097/MPH.0b013e3182002a65
    27. Rogers PC, Schoeman J. Nutritional Assessment and Intervention. In: SD, RGC., eds. Pediatric Hematology-Oncology in Countries with Limited Resources. (Vol. 2014, pp. 91-112) Springer New York. 2014.
    28. Bazzan AJ, Newberg AB, Cho WC, Monti DA. Diet and Nutrition in Cancer Survivorship and Palliative Care. Evidence-Based Complementary and Alternative Medicine. 2013;2013:1–12. Available from: https://doi.org/10.1155/2013/917647
    29. Tripodi SI, Bergami E, Panigari A, Caissutti V, Brovia C, Cicco MD, et al. The role of nutrition in children with cancer. Tumori Journal. 2023;109(1):19–27. Available from: https://doi.org/10.1177/03008916221084740
    30. Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, Bozzetti F, et al. ESPEN guidelines on nutrition in cancer patients. Clinical Nutrition. 2017;36(1):11–48. Available from: https://dx.doi.org/10.1016/j.clnu.2016.07.015
    31. Dalwai S, Choudhury P, Bavdekar SB, Dalal R, Kapil U, Dubey AP, et al. Consensus Statement of the Indian Academy of Pediatrics on integrated management of severe acute malnutrition. Indian Pediatr. 2013;50(4):399–404. Available from: https://doi.org/10.1007/s13312-013-0111-3
    32. Boullata JI, Carrera AL, Harvey L, Escuro AA, Hudson L, Mays A, et al. ASPEN Safe Practices for Enteral Nutrition Therapy Task Force, American Society for Parenteral and Enteral Nutrition. ASPEN Safe Practices for Enteral Nutrition Therapy. JPEN J Parenter Enteral Nutr. 2017. Available from: https://doi.org/10.1177/0148607116673053
    33. Ladas EJ, Blonquist TM, Puligandla M, Orjuela M, Stevenson K, Cole PD, et al. Protective Effects of Dietary Intake of Antioxidants and Treatment-Related Toxicity in Childhood Leukemia: A Report From the DALLT Cohort. Journal of Clinical Oncology. 2020;38(19):2151–2159. Available from: https://dx.doi.org/10.1200/jco.19.02555
    34. Rogers PC, Melnick SJ, Ladas EJ, Halton J, Baillargeon J, Sacks N. Children's Oncology Group (COG) Nutrition Committee. Pediatric Blood & Cancer. 2008;50(S2):447–450. Available from: https://doi.org/10.1002/pbc.21414
    35. Braegger C, Decsi T, Dias JA, Hartman C, Kolaček S, Koletzko B, et al. Practical Approach to Paediatric Enteral Nutrition: A Comment by the ESPGHAN Committee on Nutrition. Journal of Pediatric Gastroenterology and Nutrition. 2010;51(1):110–122. Available from: https://dx.doi.org/10.1097/mpg.0b013e3181d336d2
    36. Totadri S, Trehan A, Mahajan D, Viani K, Barr R, Ladas EJ. Validation of an algorithmic nutritional approach in children undergoing chemotherapy for cancer. Pediatric Blood & Cancer. 2019;66(12):27980. Available from: https://dx.doi.org/10.1002/pbc.27980
    37. Trehan A, Viani K, Cruz LBd, Sagastizado SZ, Ladas EJ. The importance of enteral nutrition to prevent or treat undernutrition in children undergoing treatment for cancer. Pediatric Blood & Cancer. 2020;67(S3):28378. Available from: https://dx.doi.org/10.1002/pbc.28378
    38. Bauer J, Jürgens H, Frühwald MC. Important Aspects of Nutrition in Children with Cancer. Advances in Nutrition. 2011;2(2):67–77. Available from: https://dx.doi.org/10.3945/an.110.000141
    39. Sacks N, Hwang WT, Lange BJ, Tan KS, Sandler ES, Rogers PC, et al. Proactive enteral tube feeding in pediatric patients undergoing chemotherapy. Pediatric Blood & Cancer. 2014;61(2):281–285. Available from: https://dx.doi.org/10.1002/pbc.24759
    40. D’Amico F, Biagi E, Rampelli S, Fiori J, Zama D, Soverini M, et al. Enteral Nutrition in Pediatric Patients Undergoing Hematopoietic SCT Promotes the Recovery of Gut Microbiome Homeostasis. Nutrients. 2019;11(12):2958. Available from: https://dx.doi.org/10.3390/nu11122958
    41. Mihatsch W, Fewtrell M, Goulet O, Molgaard C, Picaud JCC, Senterre T, et al. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Calcium, phosphorus and magnesium. Clinical Nutrition. 2018;37(6):2360–2365. Available from: https://doi.org/10.1016/j.clnu.2018.06.950
    42. Joosten K, Embleton N, Yan W, Senterre T. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Energy. Clin Nutr. 2018;37:2309–2323. Available from: https://doi.org/10.1016/j.clnu.2018.06.944
    43. Van Goudoever JB, Carnielli V, Darmaun D, Sainzde Pipaon M, Cspen EE. Working Group on Pediatric Parenteral Nutrition. ESPGHAN/ ESPEN/ESPR guidelines on pediatric parenteral nutrition: amino acids. Clin Nutr. 2018;37:2315–2338.
    44. Lapillonne A, Mis F, Goulet N, Akker OVD, Wu C, Koletzko J, et al. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Lipids. Clin Nutr. 2018;37:2324–2360. Available from: https://doi.org/10.1016/j.clnu.2018.06.946
    45. Mesotten D, Joosten K, Kempen AV, Verbruggen S, . ESPGHAN/ESPEN/ ESPR guidelines on pediatric parenteral nutrition: carbohydrates. Clin Nutr. 2018;37:2337–2380. Available from: https://doi.org/10.1016/j.clnu.2018.06.947
    46. Domello€f M, Szitanyi P, Simchowitz V, Franz A, Mimouni F, Espghan/Espen/ Espr/Cspen. Working Group on Pediatric Parenteral Nutrition. ESPGHAN/ ESPEN/ESPR guidelines on pediatric parenteral nutrition: iron and trace minerals. Clin Nutr. 2018;37:2354–2363.
    47. Mihatsch W, Shamir R, Goudoever JBV, Fewtrell M, Lapillonne A, Lohner S. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: guideline development process for the updated guidelines. Clin Nutr. 2018;37:2306–2314. Available from: https://doi.org/10.1016/j.clnu.2018.06.943
    48. Bronsky J, Campoy C, Braegger C, , . ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: vitamins. Clin Nutr. 2018;37:2366–2378. Available from: https://doi.org/10.1016/j.clnu.2018.06.951
    49. Jochum F, Moltu SJ, Senterre T, Nomayo A, Goulet O, Iacobelli S. ESPGHAN/ESPEN/ESPR guidelines on pediatric parenteral nutrition: fluid and electrolytes. Clin Nutr. 2018;37:2344–2353. Available from: https://doi.org/10.1016/j.clnu.2018.06.948
    50. Holliday MA, Segar WE. The maintenance need for water in parenteral fluid therapy. Pediatric Anesthesia. 1995;5(2):96. Available from: https://dx.doi.org/10.1111/j.1460-9592.1995.tb00251.x
    51. Mcgrath KH. Parenteral nutrition use in children with cancer. Pediatric Blood & Cancer. 2019;66(12):28000.
    52. Puntis J, Hojsak I, Ksiazyk J. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Organisational aspects. Clin Nutr. 2018;37(6):30061055. Available from: https://doi.org/10.1016/j.clnu.2018.06.953
    53. Ball S, Brown TJ, Das A, Khera R, Khanna S, Gupta A. Effect of Neutropenic Diet on Infection Rates in Cancer Patients With Neutropenia. American Journal of Clinical Oncology. 2019;42(3):270–274. Available from: https://doi.org/10.1097/COC.0000000000000514
    54. Sonbol MB, Jain T, Firwana B, Hilal T, Deleon T, Murad A, et al. Neutropenic diets to prevent cancer infections: updated systematic review and meta-analysis. BMJ Supportive & Palliative Care. 2019;9(4):425–433. Available from: https://doi.org/10.1136/bmjspcare-2018-001742
    55. Dalen ECV, Mank A, Leclercq E, Mulder RL, Davies M, Kersten MJ, et al. Low bacterial diet versus control diet to prevent infection in cancer patients treated with chemotherapy causing episodes of neutropenia. Cochrane Database of Systematic Reviews. 2016;2019(4):6247. Available from: https://doi.org/10.1002/14651858.CD006247.pub2
    56. Moody KM, Baker RA, Santizo RO, Olmez I, Spies JM, Buthmann A, et al. A randomized trial of the effectiveness of the neutropenic diet versus food safety guidelines on infection rate in pediatric oncology patients. Pediatric Blood & Cancer. 2018;65(1):26711. Available from: https://dx.doi.org/10.1002/pbc.26711
    57. Taggart C, Neumann N, Alonso PB, Lane A, Pate A, Stegman A, et al. Comparing a Neutropenic Diet to a Food Safety-Based Diet in Pediatric Patients Undergoing Hematopoietic Stem Cell Transplantation. Biology of Blood and Marrow Transplantation. 2019;25(7):1382–1386. Available from: https://doi.org/10.1016/j.bbmt.2019.03.017
    58. Bauer J, Jürgens H, Frühwald MC. Important Aspects of Nutrition in Children with Cancer. Advances in Nutrition. 2011;2(2):67–77. Available from: https://doi.org/10.3945/an.110.000141
    59. Gupta A, Gupta AK, Meena JP, Khan MA, Agarwala A, Seth R. A Pilot Randomised Controlled Trial Examining the Benefit of a Neutropenic Diet for Children Undergoing Cancer Treatment. Nutr Cancer. 2022;74(8):35225115. Available from: https://doi.org/10.1080/01635581.2022.2044060
    60. Moody KM, Baker RA, Santizo RO, Olmez I, Spies JM, Buthmann A, et al. A randomized trial of the effectiveness of the neutropenic diet versus food safety guidelines on infection rate in pediatric oncology patients. Pediatric Blood & Cancer. 2018;65(1):28696047. Available from: https://dx.doi.org/10.1002/pbc.26711
    61. Radhakrishnan V, Lagudu PBB, Gangopadhyay D, Vijaykumar V, Rajaraman S, Kalaiyarasi JP, et al. Neutropenic versus regular diet for acute leukaemia induction chemotherapy: randomised controlled trial. BMJ Supportive & Palliative Care. 2022;12(4):421–430. Available from: https://dx.doi.org/10.1136/spcare-2022-003833
    62. Trifilio S, Helenowski I, Giel M, Gobel B, Pi J, Greenberg D, et al. Questioning the Role of a Neutropenic Diet following Hematopoetic Stem Cell Transplantation. Biology of Blood and Marrow Transplantation. 2012;18(9):1385–1390. Available from: https://dx.doi.org/10.1016/j.bbmt.2012.02.015
    63. Cheung WL, Hon KL, Fung CM, Leung AK. Tumor lysis syndrome in childhood malignancies. Drugs in Context. 2020;9:1–14. Available from: https://dx.doi.org/10.7573/dic.2019-8-2
    64. Hsieh PM, Hung KC, Chen YS. Tumor lysis syndrome after transarterial chemoembolization of hepatocellular carcinoma: Case reports and literature review. World Journal of Gastroenterology. 2009;15(37):4726. Available from: https://dx.doi.org/10.3748/wjg.15.4726
    65. Howard SC, Jones DP, Pui CH. The Tumor Lysis Syndrome. New England Journal of Medicine. 2011;364(19):1844–1854. Available from: https://dx.doi.org/10.1056/nejmra0904569
    66. Mirrakhimov AE, Voore P, Khan M, Ali AM. Tumor lysis syndrome: A clinical review. World J Crit Care Med. 2015;4(2):130–138. Available from: https://doi.org/10.5492/wjccm.v4.i2.130
    67. Baumgartner A, Bargetzi A, Zueger N, Bargetzi M, Medinger M, Bounoure L, et al. Revisiting nutritional support for allogeneic hematologic stem cell transplantation—a systematic review. Bone Marrow Transplantation. 2017;52(4):506–513. Available from: https://dx.doi.org/10.1038/bmt.2016.310
    68. Baumgartner A, Zueger N, Bargetzi A, Medinger M, Passweg JR, Stanga Z, et al. Association of Nutritional Parameters with Clinical Outcomes in Patients with Acute Myeloid Leukemia Undergoing Haematopoietic Stem Cell Transplantation. Annals of Nutrition and Metabolism. 2016;69(2):89–98. Available from: https://dx.doi.org/10.1159/000449451
    69. Baumgartner A, Schuetz P, Carreras ES, Dufour C, Mohty M. The EBMT Handbook: Hematopoietic Stem Cell Transplantation and Cellular Therapies. Cham (CH. Springer. 2019.
    70. Meij BSVD, Graaf PD, Wierdsma NJ, Langius JAE, Janssen JJWM, Leeuwen PAMV, et al. Nutritional support in patients with GVHD of the digestive tract: state of the art. Bone Marrow Transplantation. 2013;48(4):474–482. Available from: https://doi.org/10.1038/bmt.2012.124
    71. Imataki O, Nakatani S, Hasegawa T, Kondo M, Ichihashi K, Araki M, et al. Nutritional support for patients suffering from intestinal graft‐versus‐host disease after allogeneic hematopoietic stem cell transplantation. American Journal of Hematology. 2006;81(10):747–752. Available from: https://doi.org/10.1002/ajh.20700
    72. Andermann TM, Rezvani A, Bhatt AS. Microbiota Manipulation With Prebiotics and Probiotics in Patients Undergoing Stem Cell Transplantation. Current Hematologic Malignancy Reports. 2016;11(1):19–28. Available from: https://dx.doi.org/10.1007/s11899-016-0302-9
    73. Bozzetti F, Arends J, Lundholm K, Micklewright A, Zurcher G, Muscaritoli M. ESPEN Guidelines on Parenteral Nutrition: Non-surgical oncology. Clinical Nutrition. 2009;28(4):445–454. Available from: https://dx.doi.org/10.1016/j.clnu.2009.04.011
    74. Muscaritoli M, Grieco G, Capria S, Iori AP, Fanelli FR. Nutritional and metabolic support in patients undergoing bone marrow transplantation. The American Journal of Clinical Nutrition. 2002;75(2):183–190. Available from: https://dx.doi.org/10.1093/ajcn/75.2.183
    75. Zheng J, Taylor B, Chen X. Role of Vitamin A in Modulating Graft-versus-Host Disease. J Immunol Res Ther. 2018;3(1):6086377. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6086377/
    76. Friedman DN, Tonorezos ES, Cohen P. Diabetes and Metabolic Syndrome in Survivors of Childhood Cancer. Hormone Research in Paediatrics. 2019;91(2):118–127. Available from: https://doi.org/10.1159/000495698
    77. Smith WA, Li C, Nottage KA, Mulrooney DA, Armstrong GT, Lanctot JQ, et al. Lifestyle and metabolic syndrome in adult survivors of childhood cancer: A report from the St. Jude Lifetime Cohort Study. Cancer. 2014;120(17):2742–2750. Available from: https://doi.org/10.1002/cncr.28670
    78. Slater ME, Ross JA, Kelly AS, Dengel DR, Hodges JS, Sinaiko AR, et al. Physical activity and cardiovascular risk factors in childhood cancer survivors. Pediatric Blood & Cancer. 2015;62(2):305–310. Available from: https://dx.doi.org/10.1002/pbc.25276
    79. Petersen NN, Larsen HB, Pouplier A, Schmidt‐andersen P, Thorsteinsson T, Schmiegelow K, et al. Childhood cancer survivors' and their parents' experiences with participation in a physical and social intervention during cancer treatment: A <scp>RESPECT</scp> study. Journal of Advanced Nursing. 2022;78(11):3806–3816. Available from: https://doi.org/10.1111/jan.15381
    80. Spreafico F, Murelli M, Timmons BW, Massimino M, Barr R. Sport activities and exercise as part of routine cancer care in children and adolescents. Pediatric Blood & Cancer. 2019;66(8):27826. Available from: https://doi.org/10.1002/pbc.27826
    81. Wells SJ, Austin M, Gottumukkala V, Kruse B, Mayon L, Kapoor R, et al. Development of an Enhanced Recovery Program in Pediatric, Adolescent, and Young Adult Surgical Oncology Patients. Children. 2021;8(12):1154. Available from: https://dx.doi.org/10.3390/children8121154

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© This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Published By India Association for Parenteral and Enteral Nutrition (IAPEN)

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